Pathological complete response after neoadjuvant treatment determines survival in esophageal squamous cell carcinoma patients (NEOCRTEC5010).

Abstract

BACKGROUND:

Few studies have exclusively investigated the value of pathological complete response (pCR), in esophageal squamous cell carcinoma (ESCC) patients, although it is a clinically significant parameter to evaluate the impact of neoadjuvant chemoradiotherapy (nCRT) on treatment outcome after surgery. The aim of our study was to explore the relationship between pCR after nCRT and survival among patients with local ESCC.

METHODS:

All patients receiving nCRT followed by surgery in NEOCRTEC5010-trial (NCT01216527) were included. Non-pCR patients were classified into three subgroups: ypTanyN0M0, ypT0NanyM0 and ypTanyNanyM0. The Kaplan-Meier method with log-rank test was employed to evaluate disease-free survival (DFS) and overall survival (OS). Multivariate regression analysis was performed using a Cox proportional hazards model to identify clinicopathological parameters associated with pCR.

RESULTS:

Among the 185 patients included, 80 (43.2%) achieved pCR after nCRT. The mean survival time of the pCR group was significantly longer than that of the non-pCR group (92.6 vs. 69.2 months; HR, 2.70; 95% CI: 1.48-4.92; P=0.001). The 5-year OS and DFS of the pCR group were 79.3% and 77% respectively, compared to 54.8% and 51.2%, respectively, in the non-pCR group. The results showed that the OS and DFS of the ypTanyN0M0 group were better than those of the ypT0NanyM0 group and the ypTanyNanyM0 group. We also found that the number of dissected lymph nodes and pCR were independent risk factors for DFS and OS rates.

CONCLUSIONS:

pCR after nCRT is an important prognostic indicator of OS and DFS in patients with ESCC. In addition, lymph-node status could represent an important parameter in the prognostic evaluation of esophageal cancer patients.

• Authors: Jianfei Shen, Min Kong, Hong Yang, Ke Jin, Yuping Chen, Wentao Fang, Zhentao Yu, Weimin Mao, Jiaqing Xiang, Yongtao Han, Zhijian Chen, Haihua Yang, Jiaming Wang, Qingsong Pang, Xiao Zheng, Huanjun Yang, Tao Li, Xu Zhang, Qun Li, Geng Wang, Teng Mao, Xufeng Guo, Ting Lin, Mengzhong Liu, Dehua Ma, Minhua Ye, Chunguo Wang, Zheng Wang, Alessandro Brunelli, Robert J Cerfolio, Xavier Benoit D'Journo, Hiran C Fernando, Florian Lordick, Jianhua Fu, Baofu Chen, Chengchu Zhu, written on behalf of the AME Thoracic Surgery Collaborative Group
• Journal: Annals of translational medicine (Ann Transl Med) Vol. 9 Issue 20 Pg. 1516 (Oct 2021) ISSN: 2305-5839 [Print] China
• PMID: 34790722 (Publication Type: Journal Article)
• Copyright: 2021 Annals of Translational Medicine. All rights reserved.